1. Field of the Invention
The invention relates to endoscopic instruments. More particularly, the invention relates to endoscopic instruments having single or double acting end effectors wherein one or both of the end effectors are provided with or define one or more lumens for suction and/or irrigation.
2. State of the Art
Endoscopic surgery is widely practiced throughout the world today and its acceptance is growing rapidly. In general, endoscopic surgery involves one or more incisions made by trocars where trocar tubes are left in place so that endoscopic surgical instruments may be inserted through the tubes. A camera, magnifying lens, or other optical instrument is often inserted through a first trocar tube, while a cutter, dissector, or other surgical instrument is inserted through another trocar tube for purposes of manipulating and/or cutting the internal organ. Sometimes it is desirable to have several trocar tubes in place at once in order to receive several surgical instruments. In this manner, organs or tissue may be grasped with one surgical instrument, and simultaneously may be cut with another surgical instrument; all under view of the surgeon.
By 1996, it is expected that more than two million additional endosurgeries will be performed per year that, in 1990, were done via open surgery (MedPRO Month, I:12, p.178). The advantages of endoscopic surgery are clear in that it is less invasive, less traumatic and recovery is typically quicker. As a result, many new instruments and devices for use in endosurgery are introduced every year.
Endoscopic surgical instruments generally include a tube, a push rod which extends through the tube, an actuating means which engages the tube and the push rod and which imparts reciprocal axial motion to the push rod, and end effector means coupled to the distal end of the tube and to the distal end of the push rod by a clevis. Axial movement of the push rod effects movement of the end effector means in a plane parallel to the longitudinal axis of the push rod. For purposes herein, the "distal end" of a surgical instrument or any part thereof, is the end most distant from the surgeon and closest to the surgical site, while the "proximal end" of the instrument or any part thereof, is the end most proximate the surgeon and farthest from the surgical site.
There are many different types of end effectors used in various endoscopic surgical instruments, e.g. grippers, cutters, scissors, jaws, etc. Moreover, end effectors may be either single acting (a first end effector element remains stationary while a second end effector element is rotated relative to the first) or double acting (both end effector elements are rotated relative to each other).
As mentioned above, during endoscopic surgery, several trocar tubes may be used to allow the use of several different tools simultaneously. In addition to a camera and various surgical instruments, it is often desirable to provide suction and/or irrigation conduits during surgery. Such conduits, which can be flexible tubes, must also be delivered to the surgical site through a trocar tube. While it is generally appreciated that the number of trocar tubes used should be kept to a minimum, it is also the general rule that only one surgical instrument or tool can be inserted through a trocar tube at any given time. Moreover, when several trocar tubes are used, it becomes difficult for the surgeon to simultaneously locate several surgical instruments at the surgical site. For example, during a particular operation, it may be desirable to provide suction and/or irrigation at the surgical site while simultaneously cutting or gripping an organ or tissue. Such a procedure typically requires at least three trocar tubes (one for the camera, one for the cutting or gripping tool, and one for the suction/irrigation tool), and the surgeon must use both hands to guide the suction and/or irrigation conduit to the site where the cutting or gripping tool is in use.